Healthcare affordability remains a leading concern across the United States, shaping decisions about insurance coverage and access to care. Approximately one-third of adults report delaying or forgoing needed care, and four in ten say they have skipped or reduced the dosage of a prescribed medication in the past year due to cost. These challenges disproportionately affect economically marginalized communities, including uninsured individuals, those with low incomes, rural residents, and Black and Hispanic populations.

State Futures in partnership with State Health and Value Strategies at Princeton University released this issue brief highlighting strategies state legislators are deploying to improve healthcare affordability, strengthen hospital financial assistance policies, and generate revenue to offset losses in federal healthcare funding. An accompanying brief, State Legislative Actions to Address Medical Debt, covers state efforts on that front.

In response to ongoing changes in federal immigration policy and enforcement, states are taking an active role in shaping how immigration laws are carried out within their borders. As federal agencies implement new strategies that raise concerns about civil rights, local authority, and transparency, state lawmakers are taking steps to clarify and shape the role of state and local governments in immigration enforcement.

In response to ongoing changes in federal immigration policy and enforcement, states are taking an active role in shaping how immigration laws are carried out within their borders. As federal agencies implement new strategies that raise concerns about civil rights, local authority, and transparency, state lawmakers are taking steps to clarify and shape the role of state and local governments in immigration enforcement.